Our results suggest that maintenance of high mitochondrial transcription and lack of inflammation in SAT are associated with low liver fat and MHO.

Low basal metabolic rate (BMR) is a risk factor for weight gain and obesity. The polymorphism at codon 64 of the beta3-adrenergic receptor gene has been suggested to be associated with BMR. We investigated the frequency of the Trp64Arg of the beta3-adrenergic receptor gene and the effects of this polymorphism on BMR in obese Finns. Altogether, 170 obese subjects (29 men, 141 women, BMI 34.7 +/- 3.8 kg/m2, mean +/- SD) participated in the study. The frequency of the Trp64Arg polymorphism was 19%. None of the obese subjects were homozygous for the Arg-encoding allele. The frequency of the Trp64Arg polymorphism in obese Finns did not differ from nonobese and normoglycemic control subjects. BMR adjusted for lean body mass and age was lower in subjects with the Trp64Arg polymorphism (n = 20) than in normal homozygotes Trp64Trp (n = 99) (1,569 +/- 73 vs. 1,635 +/- 142 kcal/day, P = 0.004). For the female group (n = 98), the respective values were 1,501 +/- 66 kcal/day vs. 1,568 +/- 127 kcal/day (P = 0.004). There were no significant differences in weight, BMI, waist-to-hip ratio, lean body mass, percentage of fat, and respiratory quotient between the groups with or without the Trp64Arg polymorphism. Neither serum glucose nor insulin levels differed between the two groups. We conclude that the Trp64Arg polymorphism of the beta3-adrenergic receptor gene affects basal metabolic rate in obese Finns but does not have significant effect on glucose metabolism.

The purpose of this study was to investigate the practices of insulin injection and the grounds on which diabetic patients make decisions in relation to insulin therapy. The data for this study were collected by a structured questionnaire with a few open-ended questions. The study group of 100 patients with type 1 diabetes was collected from two sources. The ®rst half of them (50) came from the Central Hospital of North Karelia and the second half from the Diabetes Education Centre of the Finnish Diabetes Association. The study group consisted of 56 women and 44 men. The range of age was 17±64 (mean 32 years) and the duration of diabetes 1±40 years (mean 11 years). Injection site problems were reported by 65% of the patients. Patients utilising a small skin area for injections (the size of a stamp), or patients who had poor metabolic control (HbA 1c >8.6%), reported more problems than other patients. 30% of the patients occasionally injected through clothing during unusual situations (e.g. parties, busy work etc). Occasional skipping of injections was reported by 31% of the patients for reasons such as oblivion or on purpose (e.g. low blood glucose). The most general basis for their injection routines was reported to be a habit and the other basis was patient education. The study suggests problems in insulin injection practices. Systematic checking of the injection sites and technique and the improvement of patient education are recommended.

Objective-To investigate whether girls with insulin dependent diabetes mellitus (IDDM) were more overweight than nondiabetic girls, and how diet, insulin treatment, metabolic control, age, and pubertal status were related to body weight and fat content. Design-Case-control study. Subjects This study was designed to examine whether adolescent diabetic girls were more overweight than non-diabetic girls when BMI, relative weight (a percentage of the median for height and sex), and per cent body fat were used as indicators of adiposity. We also analysed how diet, insulin treatment, metabolic control, age, and pubertal status were related to body weight and fat content. Methods SUBJECTSAll of the 10-19 year old diabetic girls attending the diabetes clinic and the adolescent clinic of Aurora Hospital in Helsinki were invited to participate in this study, which was carried out from March to June 1993. Of the 74 diabetic girls invited, 48 (65%) complied. The participants were younger than the non-participants, at 13-7(SD 2.9) v 15-6 (2.5) years, p<0-01, respectively. The age adjusted BMI of the participants was lower than that of the nonparticipants, at 20.3(3-0) v 21-9(2-9) kg/iM2, p<0 001. The participants also had lower mean HbAlc during the preceeding year than the non-participants, at 9 3 (1-7)% v 10-3 (1-8)%, p<0 05. The mean duration of diabetes among the participating girls was 5-0 (4.3) years. More than half (58%) of these girls followed a multiple insulin injection regimen (four or more injections per day), 38% took insulin three times, and 4% twice daily. The mean daily insulin dose was 090 (02) IU/kg body weight.One non-diabetic control girl was selected for each diabetic girl invited. Of the 74 control girls invited, 58 (79%) participated, but only those 48 whose diabetic pair also participated were included in the present analyses. Control girls were recruited from five local schools and matched for age (to the nearest 0 5 year) and social class with the diabetic girls. The subjects' socioeconomic status was classified into three categories according to the better placed parent12 as follows: (1) employers, self employed, and upper level employees (classes I-III, n=21), (2) lower level employees (class IV, n=20), (3) manual workers (class V, n=7).Both diabetic and control girls were on average 13 7 years old (range 10 1-19 5 years). To study the effect of age on energy intake and obesity, the subjects were subdivided into two groups: 10-13 year olds (n=23) and 14-19 year olds (n= 25). The assessment of pubertal status, based on pubic hair and breast development and the method of Marshall and Tanner,'3 was made by their treating physicians in the IDDM girls and by one of the authors (SMV, MD) in the control girls. Of

Both central and peripheral cardiovascular impairments limit VO(2peak) in physically active adults with type 1 diabetes. Importantly, central limitations, and probably peripheral limitations as well, are associated with glycemic control.